Individual provider Active NPI

Robert Clarke Maiocco, M.D.

  • Family Medicine Physician
  • Aurora, CO
National Provider Identifier
1306895578
Registry record updated Mar 30, 2014
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Jun 20, 2018.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36651 Issued in CO
Practice address
3025 S Parker Rd
Suite 100
Aurora, CO 80014-2914
Phone
(303) 481-7030
Fax
(303) 745-7665
NPI assigned
May 8, 2006
Last updated
Mar 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36651 CO Primary

Addresses

Primary practice location

3025 S Parker Rd
Suite 100
Aurora, CO 80014-2914

Mailing address

3025 S Parker Rd
Suite 100
Aurora, CO 80014-2914
Phone (720) 981-9740

Other identifiers 1

IdentifierTypeStateIssuer
01366517MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36651COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piney Creek Medical LLC Family Medicine PastSince Nov 1, 1999 Accepting new patients
Preferred Provider Services, LLC PastSince Jan 1, 2012 Accepting new patients
Healthone Clinic Services LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396137600000",
    "number": "1306895578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 S PARKER RD",
            "address_2": "SUITE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142914",
            "telephone_number": "720-981-9740",
            "fax_number": "720-981-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 S PARKER RD",
            "address_2": "SUITE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142914",
            "telephone_number": "303-481-7030",
            "fax_number": "303-745-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIOCCO",
        "first_name": "ROBERT",
        "middle_name": "CLARKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2014-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "36651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01366517",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.